| Organization Name: | S MANGNALL-HARRIS, PSYD, PMHNP, LLC |
| NPI Number: | 1114297678 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SUSAN Z MANGNALL-HARRIS (OWNER) |
| Mailing Address: | 955 W Orchard Ave Hermiston |
| State: | OR US |
| Postal Code: | 978381591 |
| Phone Number: | 5412890955 |
| Fax Number: | 5412890956 |
| NPI Enumeration Date: | 12/30/2011 |
| NPI Last Update Date: | 12/30/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | 201150002NP |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |